Individual
MARY GOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3180 PROFESSIONAL PLZ STE 101, GERMANTOWN, TN 38138-1534
(901) 328-2110
Mailing address
5143 TARRYTOWN DR, MEMPHIS, TN 38117-2125
(662) 891-7672
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7463
TN
Other
Enumeration date
06/14/2021
Last updated
06/14/2021
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